DAVID GREENE, HOST:
People in poor countries who suffer from depression and alcoholism have so few options for treatment, but there are two new studies based in India suggesting that effective treatment might be as close as a neighbor. Here's reporter Joanne Silberner.
JOANNE SILBERNER, BYLINE: For years, a nonprofit health care group in India called Sangath has been trying to figure out a way to treat more people with mental illness. There's a real need for it, says Sangath co-founder and psychiatrist Vikram Patel.
VIKRAM PATEL: The vast majority of people with drinking problems or depression have neither received a diagnosis in their life nor have they ever been exposed to psychotherapy before.
SILBERNER: There aren't many psychologists or psychiatrists in India, so Patel's group turned to the community for help. They decided to train local people to become lay counselors. These were people with a 10th-grade education or more but with no training in mental health. During an intensive three-week workshop, these lay counselors learned some of the basics of cognitive behavioral therapy, including how to find specific tests to help refocus their patients' minds.
It could be as simple as helping their patients recognize that, when a bad time is coming, they need to get up and take a walk or go to a sporting event or talk with a friend. Patel and his colleagues have just completed two large trials using lay counselors to deliver care, published online by the medical journal Lancet.
PATEL: Firstly, we found very high rate of completing the treatment - 70 percent, which is comparable to the best treatment completion rate from the Western literature.
SILBERNER: The trials started with hundreds of people with depression or alcoholism who were diagnosed at a health center and then treated by lay counselors. They compared those patients to hundreds of others who got a slightly better version of usual care - basically, a diagnosis from a physician plus a few facts about their condition.
PATEL: In the depression trial, we found significantly higher recovery rates.
SILBERNER: Two-thirds higher than those who did not see a lay counselor. And there was a lower relapse rate among alcoholics. Alan Kazdin is a professor of psychology at Yale University and headed the American Psychological Association in 2008. He says the research results of these studies and others suggest that effective treatment does not necessarily require a professional degree.
ALAN KAZDIN: These two studies are wonderful in the sense that they add to - and with elegant, very well-controlled studies - that lay counselors can do it, and they can do it on scale, so it's not just treating a few more people. And it really has broad effects.
SILBERNER: He says lay counselors are good not just for India.
KAZDIN: It's time to scale it up in the world.
SILBERNER: Many people in the U.S. also go untreated and could benefit, he says.
For NPR News, I'm Joanne Silberner.
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